Smartphone application versus written material for smoking reduction and cessation in individuals undergoing low-dose computed tomography (LDCT) screening for lung cancer: a phase II open-label randomised controlled trial

• Published in: The Lancet regional health. Europe Vol. 42; p. 100946
• Main Authors: Iivanainen, Sanna, Kurtti, Antti, Wichmann, Viktor, Andersen, Heidi, Jekunen, Antti, Kaarteenaho, Riitta, Vasankari, Tuula, Koivunen, Jussi P.
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.07.2024
• Subjects: Behavioral change technique; LDCT; Lung cancer screening; Smartphone application; Smoking cessation; Smartphone application; Smoking cessation; LDCT; Behavioral change technique; Lung cancer screening
• ISSN: 2666-7762; 2666-7762
• DOI: 10.1016/j.lanepe.2024.100946

Counseling, nicotine replacement, and other cessation medications have been proven effective in smoking cessation. The wide-scale adoption of smartphones and other mobile devices has opened new possibilities for scalable and personalized smoking cessation approaches. The study investigated whether a smartphone application would be more effective than written material for smoking cessation and reduction in smoking in individuals undergoing low-dose computed tomography (LDCT) screening for lung cancer (NCT05630950). This randomized controlled trial enrolled 201 current smokers with marked smoking history (smoked ≥15 cigarettes/day for ≥25 years or smoked ≥10 cigarettes/day for ≥30 years). Participants were stratified by age and pack-years and randomized in 1:1 fashion to the developed smartphone application (experimental arm) or written material (standard of care). All the subjects underwent LDCT screening. Self-reported smoking cessation at three and six months were the primary endpoints of the study. The smoking-related secondary endpoints of the study were the percentage of individuals who had reduced the number of smoked cigarettes/d from the baseline. Between Nov 18, 2022, and Apr 14, 2023, 201 patients were screened at Oulu University Hospital, Finland, of whom all were randomly assigned to smartphone application (n = 101) or written cessation material (n = 100); 200 were included in the full analysis set. Study arms were well-balanced for all the studied demographic factors. Subjects randomized to the smartphone application arm had significantly higher rates for self-reported smoking cessation at three (19.8 versus 7.1%; OR 3.175 CI 95% 1.276–7.899) and six months (18.8 versus 7.1%; OR 2.847 CI 95% 1.137–7.128). In the experimental arm, individuals with a frequent use of the application had a higher chance for smoking cessation at three (p < 0.001) and six months (p = 0.003). The study showed that the developed smartphone application increases the likelihood for smoking cessation in individuals undergoing lung cancer LDCT screening. AstraZeneca, Roche, and Cancer Foundation Finland.